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What is OCDOCD SubtypesWhat Is Just Right (Perfectionism) OCD?

What Is Just Right (Perfectionism) OCD?

8 min read
Nicholas Farrell, Ph.D

By Nicholas Farrell, Ph.D

Apr 14, 2021

Just Right OCD Symptoms

Just Right obsessive-compulsive disorder (OCD) is an OCD subtype that is characterized by ongoing intrusive thoughts and compulsive behaviors around organization, perfection and making things feel “just right.” People with Just Right OCD experience frequent intrusive thoughts around organization and symmetry, and they perform certain actions until they feel it is complete or “perfect” (e.g., switching a light switch on and off seven times before leaving a room). While other subtypes are motivated by specific fears and trying to avoid particular outcomes, with this subtype, the underlying anxiety is characterized by an unsettled feeling that something is just not right.

People who have Just Right OCD may fixate on parts of their body, like making sure their fingernails are the exact same length, their hair is perfectly arranged, or their makeup is applied perfectly and symmetrically. They may fixate on a certain structural asymmetry, like their nostrils, and attempt to perfect it by breathing in a certain way or spend time researching plastic surgery options that could correct it. Another common obsession for this OCD subtype is being fixated on physical sensations. So if someone touches your right arm by mistake, you must touch your left arm in the same place to “even it out”. This may also look like not avoiding stepping on cracks on the sidewalk, or making sure your steps are even.

Other people with Just Right OCD may experience doubting thoughts about their written or verbal communication. A person may fixate on certain things they’ve said, or the specific words they are using while talking, and correct themselves mid-speech if the word isn’t perfectly representing what they wanted to express. A person may feel each sentence must be exactly the same length to be perfect and rewrite them until they are. Or they may reread texts or emails over and over before and after they are sent. They may struggle to make the shape of each word symmetrical and keep on finding new ones until they are. 

Someone with Just Right OCD may also be fixated on making their surroundings look just right and symmetrical. For some people, looking at a slightly tilted picture frame or images of houses where the windows and doors are uneven can cause intense anxiety. 

The compulsions people with this subtype experience are usually pretty straightforward and centered around trying to fix what they perceive to be imperfect or incomplete. Rearranging the picture frame. Fixing their hair. Choosing the right words. Tying the shoe on their right foot to match the tension of the shoe on their left foot. Reading emails 15 times before and after sending them. These compulsions can be incredibly time-consuming and can often cause people with Just Right OCD to run late to scheduled commitments in their life. It can also be socially isolating for people when their OCD forces them to engage in physical compulsions in the presence of others (e.g., switching a light switch seven times in front of a friend. People with this OCD subtype may find themselves avoiding situations entirely so that they don’t have to deal with the time and stress required to make things just right. Instead of re-reading an email 15 times before and after sending, they’ll just avoid writing the email in the first place. Just Right OCD can demand a tremendous amount of mental energy from a person, and cause them to lose hours of their day to compulsions. 

Just Right OCD Obsessive Thoughts, Impulses and Urges: Some Examples

  • If I don’t fix this picture frame, something bad will happen. 
  • The pillows don’t look just right, and I can’t handle that – I must fix them. 
  • When I do my hair, it has to be perfectly even. 
  • I need to make sure this text message is phrased just right and gets my message across perfectly, otherwise, this person will judge me.
  • Every time I walk outside, I have to make sure I’m stepping on an even number of sidewalk cracks.
  • If someone accidentally touches my left shoulder, I have to touch my right shoulder to make it even. I won’t be able to concentrate until I do.  
  • When I’m typing, I need to make sure my fingertips on both hands are touching symmetrical keys. 
  • I can’t concentrate on my assignment until the word document is properly aligned. 
  • I’m not sure if I measured out the right amount of coffee beans for my machine, so I need to do it again. I have to make sure it’s perfect. 

Just Right OCD Compulsive Actions: Some Examples 

Fixing behaviors to make things just right: This is the most common compulsion for this subtype of OCD. When something appears out of order or incomplete, a person with Just Right OCD will try to make it right. This could mean measuring out their coffee as many times as needed until they are sure it’s the perfect amount. Or spending hours rewriting a brief email until it is perfect. The compulsion to fix things could be ritualized, like needing to turn a light switch on and off 5 times before leaving each room. It could look like repeatedly putting a shirt on until it feels right. These compulsions can range from quick activities that take a few seconds but can demand hours of a person’s day.

Avoidance: Because people with Just Right OCD experience high levels of anxiety when things appear to be incomplete, they may avoid certain situations or places where they know their OCD will likely be triggered. For example, if someone needs to make sure each handwritten letter is exactly aligned, and this process takes hours, they may find themselves avoiding writing by hand. If sending a text message consumes hours of a person’s day because they have to read it repeatedly, they may decide it’s best to stop texting. 

Reassurance seeking: In certain situations, people with Just Right OCD may turn to friends or family for reassurance. They may ask, “Does this picture frame look straight to you?” They may repeatedly ask friends for a second opinion on an email to make sure it’s coming across as they intend, or check that the person they spoke to understood what they meant to say exactly as they intended it.

Just Right OCD ERP Therapy

The best course of treatment for Just Right OCD, like all types of OCD, is Exposure and Response Prevention (ERP) therapy. ERP is considered the gold standard for OCD treatment and has been found 90% effective. The majority of patients experience results within 12 – 25 sessions.

As part of ERP therapy, you’d be tracking your obsessions and compulsions around your Just Right OCD and making a list of how distressing each thought or situation is. You’ll work with your therapist to slowly put yourself into situations that bring on your obsessions. This has to be carefully planned to ensure it’s effective and so that you’re gradually building toward your goal rather than moving too quickly and getting completely overwhelmed.

The idea behind ERP therapy is that exposure to your fears is the most effective way to treat OCD. When you continually reach out for the compulsions, it only strengthens your need to engage in them. On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond and will very likely experience a noticeable reduction in your anxiety.

Example of Just Right OCD Exposures

Let’s say you struggle with Just Right OCD and feel the need to read an email 15 times before it feels just right and you can send it. With a therapist, you’ll work toward overcoming this compulsion, with the goal of sending emails effectively and efficiently, without your compulsions interfering. A therapist may ask you to send an email without reading it at all. You might think, “That’s impossible!” If an exposure feels too overwhelming to start though, you’ll work with the therapist to find the right intensity for you. Maybe that’s reading the email twice before sending it. Once you choose a plan, you’ll work with your therapist on the emotions that come up during the exposures. It will be scary at first. It may bring up many of the fears you’ve been trying to alleviate with your compulsions (e.g., what if my email has mistakes and people judge me?) But with practice, you’ll find the intense need to engage in your compulsion will wane. You will get to a point where the anxiety subsides, and you no longer feel the need to reread your email at all. 

How to Get Help for Just Right/Perfectionism OCD

Often sufferers of Just Right OCD have been engaging in the same obsessions and compulsions since childhood. For this reason, they may come to think of their OCD as part of their personality, or something everyone just does, or something they’ve learned to live with and cannot possibly change. Just Right OCD can impose tremendous challenges for someone’s personal, professional and social life.  Even if these behaviors are something you’ve been doing since childhood, and it seems like there’s no way to overcome them, treatment is available. If you’re interested in learning about Just Right OCD and how it’s treated with ERP, you can schedule a free call with the NOCD clinical team to find out how this type of treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD telehealth app, so that you’re fully supported during the course of your treatment. You can also join our Perfectionism OCD community and get 24/7 access to personalized self-management tools built by people who have been through OCD and successfully recovered.

Learn More About Just Right OCD

Learn more about ERP
Nicholas Farrell, Ph.D

Nicholas R. Farrell, Ph.D. is a psychologist and the Regional Clinical Director at NOCD where he provides clinical leadership and direction for our teletherapy services. In this role, he works closely with our clinical leadership team to provide a high-quality training and developmental experience for all of our therapists with the aim of maximizing treatment effectiveness and improving our members’ experience. Dr. Farrell received his master's and doctoral degrees in Clinical Psychology from the University of Wyoming (Laramie, WY, USA). He served as a graduate research assistant in the Anxiety Disorders Research Laboratory at the University of Wyoming from 2010 to 2015 and completed his predoctoral internship training as a psychology resident at St. Joseph’s Healthcare Hamilton (Ontario, Canada).